My thoughts drift back to my early years of training, when for nearly 2 years I spent every third night on call in the hospital setting. One night still haunts me. more»
Interested readers can now access my latest Humane Medicine column — Hauntings: When the clinical mark is missed — recently published in the Journal of the American Academy of Physician Assistants.
Please note that all of my previously published Humane Medicine pieces can now be accessed here.
I recall seeing this mother with her older son two months ago. Unlike this robust younger brother, her first son was born 12 weeks premature and subsequently faced myriad medical problems. He grew poorly and manifested developmental delays over the first two years of life. She certainly had her hands full caring for him. more»
My latest installment of Notes from a Healer — Up to her neck — is now online, newly published in the Yale Journal for Humanities in Medicine.
The Yale Journal for Humanities in Medicine is an online journal fostering discussion about the culture of medicine, medical care, and experiences of illness. Interested readers can access a list of editorial board members and regular contributors here.
Several years ago, when I was laid up for 6 weeks with a fractured ankle and hand after a hiking accident, my wife decided to get a dog. She and my daughter drove to the pound to scout out prospective candidates. They came home with a scraggly terrier, rescued from certain annihilation. more»
Interested readers can now access my latest Humane Medicine column — Vestigial reflexes, gut reactions: When time is not enough to heal — recently published in the Journal of the American Academy of Physician Assistants.
I’ve known this mother for a long time. Far from wet behind the ears, she’s raised four other children, mostly on her own after her divorce several years ago. She’s never been one to run to the office for every sneeze and sniffle. If she brings one of her children in to be evaluated, it’s usually for a good reason. more»
Interested readers can peruse my latest JAAPA Musings blog post, newly published in the Journal of the American Academy of Physician Assistants.
Forgive me, Johann.
You were so quiet, uncomplaining
Your father seemingly so calm
Matter-of-fact in the way
He explained the course
Of your illness.
This can’t be anything serious,
I thought, as I surveyed the scene.
But then—
You cried out in pain
When I squeezed your calves,
You grimaced as you stood
Clutching the exam table,
Unable to take more than
Two halting steps toward
Your father’s outstretched arms.
I lifted you back up,
Tapped your knees with a rubber hammer
No response, no reflexive recoil
The Achilles were the same:
Absent.
Graciously, your father accepted
A copy of my note
The directions to the hospital
He lifted you into his arms
And carried you out through the door
As though you were a newborn babe
Wrapped in swaddling clothes.
Forgive me, Johann;
I neglected to say good-bye—
My next patient anxiously waited
In the wings.
2013 © Brian T. Maurer
If we should become wise, we come to understand that each of us has only the day before us to live. more»
Interested readers can now access my latest Humane Medicine column — Said and done: When the present is all we have left — recently published in the Journal of the American Academy of Physician Assistants.
As a country, we have always struggled with where our loyalties lie on the spectrum of individual rights versus government regulation. Somewhere sandwiched between the two extremes is the concept of community, where members share responsibility for the safety and welfare of those least able to protect themselves. more»
Interested readers can examine my thoughts on this issue in my latest JAAPA Musings blog post newly published in the Journal of the American Academy of Physician Assistants.
Being ‘caught in irons’ refers to a boat sitting at, or very nearly, head to wind with sails luffing and no forward motion. Left alone any boat will eventually drift out of irons with a 50-50 chance of coming out on a desired tack.
It had been a rough week in the wake of the Newtown shootings. Each morning I read the news reports before heading into the office to see my daily panel of pediatric patients — kids of all shapes and sizes, in sickness and in health. As is the case every year, those in sickness succeeded in passing some form of their ailment along to me.
General body aches and a sore throat kept me out of the pool most of the week. By the time Saturday rolled around, I sorely needed some sustained exercise to ease my battered body. I grabbed my duffel and headed to the gym.
Not many had ventured forth that afternoon. The sky was overcast; the wind was up. A few drops of rain pelted the windshield. I pulled into the parking lot and struggled to push the door open against the heavy wind.
Inside the locker room I changed into my suit, grabbed my goggles and strolled out onto the pool deck. I chose one of the vacant far lanes and immersed myself in the water.
It was a bit rough going at first, but I soon stretched out and concentrated on snapping my forearms down through the water, alternatively sweeping them back along my thighs as I slowly crawled down the length of the pool and back.
Forty laps I counted, each 25 yards in length. After a brief pause at the wall I resumed swimming, now with a pull buoy tucked between my legs. This time I swam 36 laps, or 900 yards.
I resolved to continue the trend, successively completing 800, 700, 600 yards, alternating swims and pulls. Eventually, at a quickened pace I tooled the last swim of the set — 100 yards — before calling it an afternoon. All told, I managed to log 5,500 yards; just over 3 miles in the water.
I finished up the workout with 50 push-ups and retreated to the showers.
As I sauntered down the hallway past the front desk to the exit, I felt as though I were walking on air; my body was so light, my mind so clear. All of the mental cobwebs from the past week had been brushed aside.
Outside, the intermittent rain had given way to gusts of snow flurries. It was the day after the solstice; winter had arrived.
Stepping out into the cold, I raised my eyes to the pole in the circle at the front of the facility and froze in my tracks, caught up in the moment.
The flag stood at half mast, luffing sharply in the winter wind.
To be “at sixes and sevens” is a British English idiom used to describe a state of confusion or disarray. The phrase probably derives from a complicated dice game called “hazard.” It is thought that the expression was originally “to set on cinq and six” (from the French numerals for five and six). These are the riskiest numbers to shoot for (to “set on”), and anyone who tried for them was considered careless or confused.
The first two of the 20 children gunned down at Sandy Hook Elementary School were buried in Newtown, Connecticut, today. Last evening at a town wide interfaith memorial service President Obama read the names of those who had died in the massacre.
Yesterday’s New York Times website carried the names and ages of the victims posted in stark white letters on a black rectangular background. The post was reminiscent of the black wall of the Vietnam War Memorial in Washington, D.C. All of the murdered Newtown children were either 6 or 7 years of age.
A Hemingway quote from A Farewell to Arms came to mind:
“The sacrifices were like the stockyards of Chicago if nothing was done with the meat except to bury it. There were many words that you could not stand to hear and finally only the names of places had dignity. Certain numbers were the same way and certain dates and these with the names of the places were all you could say and have them mean anything.”
And then this:
“If people bring so much courage to this world the world has to kill them to break them, so of course it kills them. The world breaks every one and afterward many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.”
Today we were busy at the office. Of the 34 kids I saw, several were 6 or 7 years old. Some were blonde, some brunette; one was a redhead. Several were missing one or two front teeth. Many were sick; a few had come in for their yearly well-child exams. Without exception, all possessed the air of childhood innocence.
After a full morning, nearly exhausted, I retired to my desk. The afternoon schedule was packed. I wondered how I would make it through the rest of the day.
I pushed my chair back, rested my head atop my folded arms on my desk and closed my eyes for a short nap.
It was almost like being back in first grade again.
It was not a particularly stressful Saturday morning to work in the office. Only three prescheduled physical examinations and a handful of sick children came in by morning’s end.
One child, a 1-month-old, my first patient of the morning, had colic. His mother reported that he wanted to feed constantly; whenever she didn’t give him a bottle he fretted, sucking on his fingers and hands. I had evaluated him one week ago for similar complaints. Since then the child gained 1-1/4 pounds, nearly three times the expected weekly weight gain. Obviously, she was overfeeding him. I suspected that part of the reason might have been because her first child was born prematurely and had a difficult time gaining weight.
Mothers nurture through feeding; a thriving baby exemplifies good maternal care, but sometimes too much of a good thing is not best.
As the morning wound down I ruminated behind my desk and reviewed the remainder of outstanding laboratory reports, signed off on a stack of physical examination forms and phoned in prescription renewals. The medical assistants finished with the filing and departed, locking the front door behind them.
I snugged the bow tie at the base of my throat, picked up my blue blazer and stepped out the side door. It was a short drive to the funeral home. By the time I arrived the lot was nearly filled with vehicles.
Inside people milled about, speaking in low tones, touching one another briefly on the arm or shoulder, exchanging whispered words. Some paused before the large displays of photographs mounted on easels in the hallway.
I stepped into the parlor, signed the guest book and found the end of the receiving line. There were stands of flowers everywhere, roses mostly — pink and red and white — done up in intricate arrangements identified by cards signed by family, friends and well-wishers.
A small silver urn stood in the center of the table; a golden crucifix rested against it. On either side lay two stacks of books — three on the left, two on the right. I noted the author of the two on the right — medical titles reflecting her area of expertise.
Most physicians don’t leave any written creative works behind; she had left two — these two texts, in addition to her two teenaged sons, who stood in the receiving line on either side of their father. Each of the three wore a pink tie. Pink, the color of the ribbon supporting breast cancer research; pink, the color of the delicate rose in full bloom; pink, the color of fading rose petals at the close of day.
My words were inadequate — “I’m sorry for your loss” — followed by handshakes and brief smiles.
“How are things at the office?” the father asked.
“Busy,” I said. “Back to school physical exams, you know. It’s the same every fall.”
He nodded. “Thanks for stopping by.”
I left by the side door and stepped out into the heat of the early afternoon sun.
As practicing clinicians we are granted the high privilege of glimpsing the struggles of families entrusted to our care. For brief periods were share in their triumphs, their joys and ultimately, their grief.
But many times it’s the grief that seems to linger the longest.
2012 © Brian T. Maurer
